Monday, August 31, 2009

Sen. Feinstein has issued, at long last, a thoughtful statement on health reform. There is much to applaud, but there is too much unresolved. She makes the case that this is a vital issue for our state. We should demand clearer leadership on her part.

She rightly notes that California stands to benefit from reducing our high percentage of uninsured, and must protect our extensive system of public hospitals and safety net clinics. She recognizes that most Californians want relief both from the health insuranceindustry’s exorbitant premiums and from its unfair practices. She demands that private insurance companies limit spending on administration and profits to no more than ten percent of revenues – a critical issue, and a level even better than the House’s bill. She supports offering the option of a public insurance plan.

However, while criticizing current proposals for not going far enough to assure that health care will be affordable, she opposes the necessary subsidies on abstract grounds of deficit control. She takes the opportunity for an unjustified swipe at entitlements generally, reviving the call for a commission to review not only Medicare, which is threatened by runaway costs in the private system that it cannot control, but also Social Security, a perfectly solvent system that requires well known tweaks to survive with no difficulty.

Finally, she bows to the possibility that a nonprofit coop could take the place of a public plan, in providing an effective and competitive counterpoint to private insurance. This concept has no legs, as everyone knows but the small-state senators whose judgment she questions.

Sen. Feinstein does not serve on the Senate Finance Committee, which has yet to offer a bill. But the people of our state desperately need reform, and we’ve fought for it actively. We have twice passed single payer legislation, the gold standard for effective reform. It is time for Sen. Feinstein to join the majority of the state’s Congressional delegation in unequivocal support for a bill that includes a meaningful public plan option, available to everyone, and that finally makes health care affordable. She’s halfway there. She should complete her deliberations by the time the Senate reconvenes next week.

Saturday, August 15, 2009

Ever had your pocket picked? Chances are they charmed you, scared you, surrounded you - in short, distracted you while they grabbed your wallet. Enough said.

So let's get back to the important issue in health reform: the Public Plan. You can have health coverage that is better than what you have, that is more affordable, covers many more of us, and improves quality You need a strong public plan.

The Congressional Progressive Caucus isn't calling for a strong public plan, really. They should.

People who say a public plan can't work are wrong. They should reconsider.

A strong public plan should be open to everyone who's not on Medicare, beginning in 2010.

The House bill says it would start in 2013 - after the next presidential election - and include only a few of us - self-employed, unemployed, employees of small businesses.

The Senate is proposing to have no public plan at all - just a straight cash transfer to your friendly neighborhood insurance conglomerate. (Which is really a way of making sure nothing passes.)

Why does this matter? The public plan needs to have enough people in it so that it can do what Medicare does: influence how the rest of the system works. Bend the cost curve. Improve quality. Provide your doctor, nurse practitioner and acupuncturist with comparative effectiveness studies so you get better care on the first visit. This will scare some of the teabaggers and it apparently scares the hell out of the insurance industry.

This, however, is change we can believe in.

That plus one more thing: we need a state option for single payer, so we can take the next step towards truly universal coverage.

People are mobilizing in remarkable ways to demonstrate why we need real health reform now. Giving out free care to long lines of people in desperate need. Showing up in scrubs at Town Hall meetings. Explaining that Medicare is a government program and we like it.

We need to do one more thing: make it worth it when we win. Take a picket sign for a Real Public Plan. Tell your neighbors. Tell your member of Congress. Tell your talk shows. The insurance industry and their pickpockets do not speak for us. We need real health reform, and this is the time to fight for it.

Sunday, August 9, 2009

Missing the point: Facing down the gangs disrupting her Town Hall on health reform last week with cries against the "government takeover," HHS Secretary Kathleen Sebelius responded, "But this isn't a single payer plan!"

Single payer advocates, recognizing that our gold standard cannot pass this year, taunt supporters of a public plan for saying that our gold standard cannot pass this year.

Meanwhile, the economic stagnation that gripped the poor in the 1990s and never let up is nipping at the heels of the middle class. The financial and housing meltdowns are taking place at a time when countervailing forces to corporate power are hard to find. Private sector unionization rates hover at about 7.6% (the public sector is over 40%; 16 million of America's 130 million wage workers belong to a union).

The public may be favorably disposed toward a public health plan, but probably fewer than 100 can describe how it would work, when it would start (2013), or what it would mean to them personally (would likely help). Meanwhile, right wing blogs and the Republican party are succeeding in whipping up fury on an issue even wonks think of as arcane. Let's assume most of these people are operatives, as were the Bush v. Gore mobs in 2000. The point is, they have organized, well-funded leaders, with a stake in the direction of this wobbly nation and our increasingly ethereal economy.

Maybe we need to rethink the conversation we need to be thinking about.